Our hospitals are capable of doing much better

When Dr Ouma Oluga, Secretary General of the Kenya Medical Practitioners and Dentists Union threatened a nationwide doctors’ strike last year, no one was prepared for the suffering that followed. The Government, apparently, had reneged on a signed Comprehensive Bargaining Agreement signed in 2013 and needed a little electric shock treatment to get it out of its lethargic stupor.

Dr Oluga’s ‘mother’ of all strikes, sadly, is stained with the blood of those who died crying for help at hospital gates, by the roadside and in hospital wards where stethoscopes and white jackets had become a rarity. But despite the ignominy of the strike, one of the demands by doctors was an enabling work environment.

Indeed, most public hospitals are in a sorry state. Obsolete machinery, lack of beds, poor staffing, lack of medicines and consumables define our hospitals. A medic who has to dress someone’s suppurating wound but has no gauze, bandages, antiseptics, anti-biotics or gloves to protect himself is as useful as the patient on the next hospital bed.

The Sh38 billion Managed Equipment Services Programme, though noble from the outset, has slowed down. Most of the machines have already broken down for lack of qualified technicians to service them. Some are lying idle for lack of trained personnel to operate them while in some cases, the absence of special equipment has led to deaths. In 2016, for instance, Alex Madaga lost his life after spending 18 hours in an ambulance outside Kenyatta National Hospital.

Research Institute

A study by the Kenya Medical Research Institute (KEMRI) lays doubt on the quality of diagnosis being conducted in public hospitals. Recent studies show that testing for brucellosis using the standard Febrile Antigen Brucella Agglutination Test (FBAT) has such a high margin of error it is worrying.

Of 75,256 people who tested positive for brucellosis in 2012, a new study shows only 1 per cent were infected. In a more recent study conducted on 825 using FBAT, 19 per cent tested positive for brucellosis but a different test method called Rose Bengal Test (RBT) proved only one per cent were infected.

Brucellosis treatment is expensive. While as a start patients might be required to take a strong antibiotic like Levobact for three weeks, it does not come cheap.

Other than the cost factor, scientists warn that the wrong use of antibiotics causes drug resistance and in some cases cancer. There has been an upsurge in cancers that is unexplained, yet it would not be too far-fetched to assume most are caused by some of the suspect drugs in the market.

Because of obsolete testing gear, the situation is so bad simple tests like malaria, typhoid and pneumonia are no longer reliable. The Kakamega Provincial Hospital refers patients to the Moi Teaching and Referral Hospital in Eldoret for tests like electrocardiogram (ECG). Last year, there were reports that a shortage of syringes in some Government hospitals led to boiling syringes for reuse.

The dangers this poses cannot be over emphasized. There have been cases where honest laboratory technicians urge patients to get tests from private labs where, due to modern testing kits, results are more dependable.

The availability of generic drugs, though benefiting the less financially endowed, has come with negatives. First, while there are allocations for the purchase of quality medicines in the Ministry of Health’s budget, lax quality control methods have led to the procurement of substandard medicines, allowing a few individuals to skim funds off the top. Secondly, fake drugs, not generics, permeate the market.

At some point, ordinary chalk found itself in the market camouflaged as paracetamol. The difference in prices of antibiotics used in the treatment of say, typhoid, costing between Sh5,000 and Sh200 should raise the red flag. This disparity points to compromise in quality and effectiveness.

On the positive side, the case of the conjoined two years twins, Blessings and Favour, who were successfully separated at Kenyatta National Hospital last year shows we have the potential of being up there with the best.

The Moi Teaching and Referral Hospital (MTRH) successfully operated on Margaret Apoya in 2001 to remove giant tumorous growth in her breasts.

Early this month, MTRH carried out the first cornea transplant. It is left to imagination how far we can go with a little dedication to work and prudent management of public funds.

Mr Chagema is a correspondent at The [email protected]